This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

To understand and identify better the discrete processes of clinical care which produce neurologic injury subsequent to cardiac surgery.

To modify these processes of clinical care during cardiac surgery to reduce a patient's risk of developing a neurologic injury. The research combines the use of outcomes research with continuous quality improvement to redesign processes of cardiac surgery to reduce a patient's risk of developing a neurologic injury.

Career Goals: Dr. Likosky is an Assistant Professor in the Departments of Surgery and Community and Family Medicine at Dartmouth Medical School. He received his PhD from Dartmouth in Evaluative Clinical Sciences followed by a National Research Service Award (NRSA) post-doctoral fellowship. He is committed to a career in health services research and specifically, surgical outcomes research. Ultimately, he would like to become a Professor in Surgery working on improving the outcomes of patients undergoing surgical procedures.

Progress to Date: Dr. Likosky had a publication stemming from his efforts to redesign care as detailed in Aim #1. Sixty-four subjects have been enrolled from the Catholic Medical Center and 35 have been recruited from Dartmouth-Hitchcock Medical Center. Regarding Aim #2, the grantee published findings regarding the role of biomarkers as an endpoint for evaluating care.

Future Plans: The grantee will focus on:

Developing a list of proposed changes to reduce each mechanism of brain injury.

Developing a list of registry fields to track performance.

Developing a manuscript from the analyses regarding hypotension and cerebral hypoperfusion.

Submitting a R01 to fund further investigations.

Highlights and Specific Accomplishments:

Recipient of numerous academic honors.

Co-director of the Surgical Outcomes Assessment Program in the Department of Surgery.